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Emotional casualties of war

We owe it to our soldiers to help them find ways to cope -- and to truly come home

By Lisa Wirthman

Posted:
04/27/2012 04:36:29 PM MDT

Updated:
04/27/2012 04:36:44 PM MDT

"Lost," by Anthony Ngo, a painting he did for the Military Creative Expressions class. The course is a partnership between AspenPointe Enterprise and the Colorado Springs Fine Arts Center. (Special to The Denver Post)

There are lessons in the murder of 17 civilians in Afghanistan last month, for which Army Staff Sgt. Robert Bales faces criminal charges.

But those lessons aren't in understanding how a lone soldier could commit one horrible act. They're in comprehending the repeated horrors of war we've asked our troops to face for 10 years, and the invisible wounds left behind.

Our wars in Iraq and Afghanistan have been fought by less than 1 percent of Americans, a volunteer military serving repeated deployments with little time to decompress in between.

"Our soldiers and our Marines are exhausted on a cellular level," says Marshele Waddell, wife of a 25-year Navy SEAL and author of an upcoming book, "Wounded Warrior, Wounded Home: Hope and Healing for Families Living with Combat-related PTSD."

More than 2 million troops served in Iraq and Afghanistan. Nearly one in five of those veterans suffer PTSD or serious depression, according to a 2008 Rand Corp. study.

Symptoms of PTSD, an anxiety disorder, include hypervigilance, outbursts of anger, recurring nightmares and emotional isolation.

Many would argue that mental trauma should not be an excuse for killing civilians. Indeed, if Bales is found guilty, he should be held accountable.

Yet we must also understand that for troops facing random violence from unseen enemies, the line between fighting terrorists and protecting civilians is often blurred.

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In Afghanistan, local roads are the new front lines. A favorite weapon of the Taliban is the improvised explosive device — roadside bombs trig-gered by radio signals, cellphones, or direct contact. IED attacks are random and devastating — and the biggest killer of American forces, says the Department of Defense.

Retaliation is difficult against unseen enemies, creating frustration and anger for troops with no down time. Blurring the lines further, IEDs have killed more civilians than either coalition or Afghan troops.

That frustration is manifest in recently published photos showing troops posing with body parts of insurgents who killed themselves in suicide attacks and while planting bombs.

Almost all the men in the photos had friends killed or wounded by bombs or suicide attacks, said the soldier who leaked the photos to the Los Angeles Times.

Roadside bombs have made PTSD and traumatic brain injuries signature injuries of our wars in Iraq and Afghanistan. While explosions can cause physical brain injuries, the violence of the attacks can cause PTSD. Often the symptoms overlap, making diagnosis difficult.

Two classic contributors to PTSD are exposure to an event that creates a strong fear, and a feeling of helplessness to do something about it, says Linda Corum, pediatric and family liaison for AspenPointe Counseling Services in Colorado Springs. Other risk factors for PTSD are previous traumas and the multiple deployments experienced by nearly half of our active and reserve members.

Although PTSD can worsen if untreated, many service members don't seek help because of a perceived stigma, or fear it will damage their careers. Some turn to alcohol and drugs to self-medicate the pain, creating even more problems.

Suicide rates in the military rose 80 percent from 2004 to 2008, says a March study. Domestic violence is also two to three times more likely for Iraq and Afghanistan war veterans with PTSD than those without, studies show.

Can PTSD also trigger the extreme violence of which Robert Bales is accused? While research doesn't show a direct cause and effect between PTSD and extreme violence, those who live with and treat PTSD say anything is possible.

"If enough things are in place at the right time, and with the right intensity, the outcome could be something as tragic as this loss of life," says Corum.

Perhaps no community understands the tragic connection between war trauma and violence better than Colorado Springs. Between 2005 and 2008, 14 soldiers from Fort Carson — many from one combat-battered battalion — were involved in a string of homicides in Colorado Springs.

The soldiers said that when they came home, they received little help with PTSD, instead self-medicating with substance abuse. Some started a pattern of smaller crimes that spiraled into violent events.

A July 2009 military report on the homicides said the synchronicity of several factors — among them unresolved individual issues, roles of leaders and intensity of combat experiences — may have increased the risk for violent behavior.

Bales is not a poster boy for PTSD. "I don't think it's fair to all the other warriors to say that this is your destiny or who you're going to become," says Waddell.

But neither can we turn a blind eye to the wide-ranging impacts of PTSD on service members, their families and communities.

If Fort Carson and Colorado Springs offer a local example of the trauma of war, they also model ways to heal its wounds.

It took courage for Major Gen. Mark Graham, former commander at Fort Carson, to speak openly about the violence there and champion improvements in mental health care. Graham's son, Kevin, an ROTC cadet, committed suicide in 2003. His other son, Jeff, was killed by a roadside bomb in Iraq the following year.

Graham harnessed his grief and made Fort Carson a testing grounds for new ideas about suicide prevention and caring for our troops.

Since the rash of violence at the base, Fort Carson expanded its staff of behavioral health providers about 300 percent, and hired more social workers and licensed therapists to help families, says Dr. Anne League, acting chief of the Department of Behavioral Health at Fort Carson.

In 2008, Fort Carson also started a model program (now replicated throughout the Army) of embedding teams of providers within each of Fort Carson's four brigades. "We've tried to destigmatize getting psychological help by putting behavioral health teams out there where these soldiers live," says League.

It also took compassion in the aftermath of violence for Colorado Springs residents to put aside fear and judgment to help its military community.

Outreach includes a Military Ministry Partnership, a collaboration of different faith groups; an extensive network of behavioral health providers; and a unique art program for service members with PTSD.

Colorado Springs also launched the state's first Veterans Trauma Court in 2009. It helps veterans charged with lesser felonies receive help with PTSD and substance abuse, while still holding them accountable.

Vietnam veteran Rich Lindsey, lead peer monitor for the court, says most participants have never been in trouble before. "Nobody's getting away with anything, but they're finally getting the help they should have gotten sooner," he says.

Compassion, when genuine, produces relationships that can lead to healing and hope, says Waddell.

We all benefited from our military's service. Now we must unite as a community to connect with our wounded troops, understand their sacrifices, and help them truly come home.

Lisa Wirthman (lisawirthman@yahoo.com) is a freelance journalist living in Highlands Ranch. Follow her on Twitter: @LisaWirthman.

By the numbers

PTSD can result from experiencing an event that creates a strong fear of injury or death, and creates feelings of helplessness to do something about it.

War zone experiences reported by members of the U.S. military in Iraq:

60 percent Being attacked or ambushed

86 percent Receiving incoming fire

50 percent Being shot at

36 percent Discharging weapon

63 percent Seeing dead bodies or remains

79 percent Knowing someone seriously injured or killed

Source: Department of Veterans Affairs. Percentages based on a sample of troops serving in Iraq in 2006.

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